An audit on the delivery of diabetes care practices at a tertiary care hospital in Sri Lanka

Introduction: Type 2 diabetes mellitus (T2DM) is a major non-communicable disease in Sri Lanka, with rising prevalence and associated high morbidity due to chronic complications. Despite the availability of national and international guidelines, adherence to standard diabetes care practices in busy outpatient settings remains suboptimal. This audit aimed to assess the quality of diabetic care and screening for complications at a medical clinic in a tertiary care medical unit in central province, Sri Lanka.Methods: A clinical audit was conducted over one month (April–May 2023) among patients aged ≥18 years with T2DM attending a tertiary care medical clinic. Every third eligible patient was recruited. Data were collected using a validated, interviewer-administered questionnaire and clinic records. Audit standards were based on National guidelines for management of diabetes (2021) and the American Diabetes Association (ADA) (2022) recommendations.Results: Among 140 participants (76 females, 64 males) with a mean age of 62.79 (±10.4) years, monthly blood glucose monitoring (91.43%) and blood pressure recording (100%) met audit standards. However, only 42.86% underwent glycated haemoglobin (HbA1c) testing within six months. Body mass index (BMI) and waist circumference were recorded in just 8.57% and 2.86% of patients, respectively. Annual electrocardiography (ECG) and biannual lipid profiles were done in 40% and 55.71%, respectively. Microalbuminuria screening was notably low (8.57%). Retinopathy screening was completed in 51.43% of patients, while neuropathy screening was not performed in any. Only 25.71% received dietary counselling and 20% were advised on physical activity.Conclusions: This audit highlights key deficiencies in metabolic monitoring, complication screening, and lifestyle counselling in a tertiary care medical clinic. Structured care pathways and regular audits are essential to improve compliance with established diabetes care standards.